Biomaterial Database

[Intramedullary pressure in intramedullary nailing of the femur and tibia]. 1994

D Heim, and U Schlegel, and S M Perren

Chirurgische Abteilung, Spital Davos.

Intramedullary nailing of shaft fractures of the femur and tibia is a recognized operative procedure and its use has even been enlarged by the introduction of the so-called interlocking technique. In recent years case reports have been published describing peroperative pulmonary embolism during reamed femoral nailing, suggesting either an unfavorable effect of the reaming or the pressure increase in the medullary cavity while reaming and nailing. In an in vitro study on explanted human femora and tibiae we investigated the intramedullary pressure increase in reamed and unreamed nailing procedures of both bones. A lower pressure increase was noted in unreamed nailing compared to reamed nailing in the femur (289/496 mm Hg) and in the tibia (128/>833 mm Hg). The unreamed tibial nailing displayed significantly less pressure increase than the unreamed femoral nailing (p = 0.01). Opening of the medullary cavity with the so-called cheese cutter (cannulated cutter over a centering pin) showed significantly greater pressure increase in the femur than in the tibia (p = 0.01). Pressure increase seems to be dependent of the mode of insertion of the unreamed nail (ram-blows versus manual insertion), although the difference in the tibial unreamed nailing is statistically not significant.

UI	MeSH Term	Description	Entries
D007431	Intraoperative Complications	Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.	Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D011655	Pulmonary Embolism	Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.	Pulmonary Thromboembolism,Thromboembolism, Pulmonary,Embolism, Pulmonary,Embolisms, Pulmonary,Pulmonary Embolisms,Pulmonary Thromboembolisms,Thromboembolisms, Pulmonary
D001853	Bone Marrow	The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells.	Marrow,Red Marrow,Yellow Marrow,Marrow, Bone,Marrow, Red,Marrow, Yellow
D004620	Embolism, Fat	Blocking of a blood vessel by fat deposits in the circulation. It is often seen after fractures of large bones or after administration of CORTICOSTEROIDS.	Fat Embolism,Fat Embolism Syndrome,Embolisms, Fat,Fat Embolisms
D004867	Equipment Design	Methods and patterns of fabricating machines and related hardware.	Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005264	Femoral Fractures	Fractures of the femur.	Femoral Fracture,Fracture, Femoral,Fractures, Femoral
D005594	Fracture Fixation, Intramedullary	The use of nails that are inserted into bone cavities in order to keep fractured bones together.	Intramedullary Nailing,Nailing, Intramedullary,Osteosynthesis, Fracture, Intramedullary,Fixation, Intramedullary Fracture,Fixations, Intramedullary Fracture,Fracture Fixations, Intramedullary,Intramedullary Fracture Fixation,Intramedullary Fracture Fixations,Intramedullary Nailings,Nailings, Intramedullary
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006874	Hydrostatic Pressure	The pressure due to the weight of fluid.	Hydrostatic Pressures,Pressure, Hydrostatic,Pressures, Hydrostatic
D001696	Biomechanical Phenomena	The properties, processes, and behavior of biological systems under the action of mechanical forces.	Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic